Use a team approach to help aging seniors with life resource planning
By Thomas Day
The National Care Planning Council
From my experience of 12 years in using a team approach to helping aging seniors, I have learned one important lesson.
Practitioners with a financial or legal background who help aging seniors do not adequately grasp the work that practitioners with a social work, gerontology or nursing background perform with aging seniors. Likewise, practitioners with a social work, gerontology or nursing background who help aging seniors do not adequately grasp the nature of the services performed by practitioners with a financial or legal background.
I would like to categorize these two different approaches to assisting aging seniors into two camps. One I will call financial/legal specialists and the other I will call care management specialists. Individuals who work in one or the other of these camps have chosen their profession because they derive their identity by working in the one area or the other. Seldom have I found anyone who can work in both areas comfortably at the same time.
These two groups perceive their role serving seniors entirely differently. Financial legal specialists focus on tangible products or specific services to solve specific problems. Care managers take a holistic approach to serving their clients and use whatever means necessary to make life easier for their clients and their families. The perceptions of these two camps — like trying to mix oil and water — makes communication between these two approaches difficult.
Based on their divergent perceptions of serving clients, practitioners in both areas do not completely understand what their opposite camp actually does, nor do they care to know. Aging seniors need assistance in both areas of support, and no solo practitioner can suitably offer services in both camps. The only solution that I have found that works in meeting the needs of aging seniors is to have both of these groups collaborate as a team to solve the problems. It must be done correctly. Problems are not adequately addressed if one or the other camp simply refers out services to other practitioners, and there is no unified approach in place in order to make sure that all of the services are integrated together under one master plan.
A financial specialist and a care manager often need to collaborate on producing an effective master plan, which I will hereafter call a "life resource plan." Nevertheless, it is necessary to have the financial specialist take the lead in promoting and implementing a life resource plan. This is true because many aging seniors often do not need any additional support from care management specialists or the services they bring together. If we were to rely on the care manager to take the lead in promoting and putting together the plans, we would not be serving the entire population of aging seniors who need life resource planning. On the other hand, all aging seniors have, at a minimum, a need for examining their financial situation.
In order to ensure the participation of the care manager, a portion of the fee for the plan is set aside as a retainer for that practitioner. For example, a plan may cost $900, but $150 is set aside in a fund to reimburse the gerontologist (care manager) when she is needed. Because every plan will not result in the need for an assessment from our gerontology specialist, this fund will grow to help cover her services without additional fees from the client.
When the need is uncovered in the plan, the planner schedules an appointment with the care manager to do an assessment. This assessment will often uncover the need for other services such as private duty home care, home remodeling or repair, the need for a facility with accompanying downsizing and moving, the need for fiduciary services and the list goes on and on.
The care manager is reimbursed through a retainer planning fee to conduct this initial assessment. If a more thorough assessment or ongoing management is indicated, then the client will have to pay additional fees for that work. Likewise, if the services of any other team member are uncovered through this assessment, an initial free consultation will be scheduled for each team member that is needed. The client may have to pay additional fees for these new services that are uncovered.
Please note that this approach to planning does not involve referring out services to some other entity and hoping that the client and the other entity eventually connect. An integral part of every life resource plan is the scheduling of an appointment — where it is needed — with other members of the team and the client to ensure that solutions are addressed adequately. An accounting from all members of the team will be made in a monthly meeting with all team members. The following professional service providers or advisors can be members of the life resource planning team.
- care manager
- elder financial advisor
- aid and attendance specialist
- elder law attorney
- Medicaid planner
- reverse mortgage specialist
- geriatric health care provider
- house call physician or geriatric nurse practitioner
- long-term care insurance specialist
- Medicare supplement and advantage plan specialist
- move manager or real estate agent specializing in seniors
- downsize specialist
- seniors' moving company
- home modification and remodeling
- home maintenance, yard services and chore services
- assisted living placement
- home health agency
- hospice provider
- medical equipment
- medical alert, home monitoring and home safety
- funeral pre-planning
- tax planner/CPA
- fiduciary services provider
When we originally started with this team process for supporting aging seniors about six years ago, we believed that the support groups would hang together and continue to function together based on the networking possibilities. Experience has shown us that networking eventually fizzles and the groups eventually dissolve. Over the past two years, we have been in the process of developing a solution-based planning approach to provide the glue to hold the group together.
It turns out this is the missing ingredient that makes it work: Members of the team hang around, not because they expect referrals or expect to give referrals, but because they will receive business opportunities from the planning process. The loyalty of group members is proportional to the strength of the planning process that is performed by the two key members: the financial/legal practitioner and the care manager. Doing a large number of plans and providing strong service to clients keeps team members involved. Fewer plans and poor follow-up result in less interest for team members to participate.
Members of the resource planning team typically are not part of a formally organized business structure. All of them have their own businesses to take care of. They will participate on a part-time basis as members of the team because of the extra income opportunities that life resource planning brings them. This does not mean that a formal organization devoted to life resource planning could be formed for this purpose. Many law firms have adopted a program similar to life resource planning where the firm has care management individuals on staff to provide the needed services to clients of the law firm. The difference is that life resource planning is a much more comprehensive approach to solving the problems of aging seniors and doesn't require the overhead of maintaining salaries for individual practitioners of the team.
Under this model, the care planning team is an alliance of like-minded practitioners and advisors. They will stick together and present themselves to the community as a unified team with one-stop shopping services for aging seniors. The group website, presentations from members of the group, a common name and brochures identifying the group create business opportunities for the members that they could not create on their own with their own enterprises. The unique services of such a group are recognized by centers of influence in the community and these referrers will more readily recommend the services of the team over the individual members of the group representing their own businesses. In order to help the team with its promotion and advertising endeavors, members will contribute money to support efforts for community recognition, for community-perceived presence and for the credibility of the group.